Supply problems with Efcortesol used in the management of Adrenal Crisis

The sole UK manufacturer of liquid injectable hydrocortisone – Efcortesol (hydrocortisone sodium phosphate) – has withdrawn supplies pending validation and licensing approvals of its new active ingredient supply. They now give an estimated availability date of September.

Alternative forms of liquid injectable steroid, such as dexamethasone, are not advisable for emergency treatment due to their delayed onset. The alternative preparation of injectable hydrocortisone – Solu-Cortef (hydrocortisone sodium succinate) – should be substituted. This should be prescribed as the IV/IM pack, with 100mg powder and solvent (2ml sterile water).

Patients should be given training as the Solucortef pack needs mixing of the powder and water vials prior to administration ( www.addisons.org.uk/emergency) .  We will inform you of any changes in this important area when we have any update from the manufacturers.